Related Experiment Video

Updated: Jun 16, 2026

Measuring Post-Stroke Cerebral Edema, Infarct Zone and Blood-Brain Barrier Breakdown in a Single Set of Rodent Brain Samples
04:32

Measuring Post-Stroke Cerebral Edema, Infarct Zone and Blood-Brain Barrier Breakdown in a Single Set of Rodent Brain Samples

Published on: October 23, 2020

8.0K

Cerebral hemodynamics and stroke risks in symptomatic intracranial atherosclerotic stenosis with internal versus

Shuang Li1, Xuan Tian1, Bonaventure Ip1

  • 1Department of Medicine & Therapeutics, the Chinese University of Hong Kong, Hong Kong SAR, China.

Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism
|October 28, 2023
PubMed

Insights

Internal and cortical borderzone infarcts in middle cerebral artery stenosis have different causes. Low pressure ratio indicates impaired flow in internal borderzone infarcts, while cortical infarcts suggest embolism. Internal borderzone infarcts have a higher short-term stroke recurrence risk.

Area of Science:

  • Neurology
  • Vascular Neurology
  • Neuroimaging

Background:

  • Intracranial atherosclerotic stenosis, particularly of the middle cerebral artery (MCA), can lead to borderzone infarcts.
  • Borderzone infarcts are classified as internal (IBZ) or cortical (CBZ), potentially arising from different pathophysiological mechanisms.

Purpose of the Study:

  • To investigate the distinct mechanisms underlying internal borderzone infarcts (IBZ) and cortical borderzone infarcts (CBZ) in patients with middle cerebral artery (MCA) atherosclerotic stenosis.
  • To correlate infarct patterns with hemodynamic factors and assess subsequent stroke risk.

Main Methods:

  • Eighty-four patients with symptomatic 50-99% MCA-M1 atherosclerotic stenosis and acute borderzone infarcts were analyzed.
  • Infarct patterns (isolated IBZ, isolated CBZ, IBZ+CBZ) were classified using diffusion-weighted imaging.
  • CT angiography and computational fluid dynamics (CFD) models quantified the pressure ratio (PR) across the MCA stenosis.

Main Results:

  • Patients with IBZ infarcts were more likely to have a low PR, indicating impaired antegrade flow (p=0.012).
  • Patients with CBZ infarcts were more likely to have coexisting small cortical infarcts, suggesting embolism (p=0.004).
  • Low PR was independently associated with isolated IBZ infarcts (aOR=4.223; p=0.026).
  • Isolated IBZ infarcts showed a higher risk of same-territory ischemic stroke recurrence within 3 months compared to isolated CBZ infarcts (17.9% vs 0.0%; p=0.023).

Conclusions:

  • Internal and cortical borderzone infarcts in MCA stenosis likely result from different mechanisms: impaired flow for IBZ and embolism for CBZ.
  • Hemodynamic assessment using PR may help differentiate infarct mechanisms.
  • Patients with isolated IBZ infarcts face a higher short-term risk of recurrent stroke compared to those with isolated CBZ infarcts.

Keywords:
Borderzone infarctcerebral hemodynamicsintracranial atherosclerotic diseaseischemic strokeprognosis

More Related Videos

Performing Permanent Distal Middle Cerebral with Common Carotid Artery Occlusion in Aged Rats to Study Cortical Ischemia with Sustained Disability09:11

Performing Permanent Distal Middle Cerebral with Common Carotid Artery Occlusion in Aged Rats to Study Cortical Ischemia with Sustained Disability

Published on: February 23, 2016

21.8K
A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia06:01

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia

Published on: August 18, 2015

14.9K

Related Concept Videos

Ischemic Stroke ll: Pathophysiology01:15

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
Ischemic Stroke l: Introduction01:15

Ischemic Stroke l: Introduction

Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...